Primary care And Out Patient Clinics

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1. The Breathalyzer device's mouthpiece is a one time use and must be discarded after the test.  

Explanation

The statement is true because the mouthpiece of a Breathalyzer device is designed to be used only once and then discarded. This is done to maintain hygiene and prevent cross-contamination between users. Reusing the mouthpiece could lead to inaccurate test results and potential health risks. Therefore, it is important to use a new mouthpiece for each test.

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About This Quiz
Nursing Quizzes & Trivia

This Primary Care and Out Patient Clinics evaluates essential knowledge related to primary care and outpatient clinic protocols, emphasizing the roles and responsibilities within nursing teams. It focuses... see moreon when Licensed Practical Nurses (LPNs) must notify Registered Nurses (RNs), the proper initiation of medical orders, and strict adherence to Patient Aligned Care Team (PACT) protocols.

Understanding these elements is vital for ensuring smooth clinic operations, effective communication, and high-quality patient care. The quiz also highlights the importance of teamwork and clear role delineation to optimize patient outcomes. Designed for nursing professionals working in outpatient settings, this assessment helps reinforce best practices and compliance with clinical guidelines. Use this quiz to strengthen your grasp of primary care workflows and enhance your ability to deliver coordinated, efficient care in outpatient environments. see less

2. The clinic has a fan-out/call back system if an emergency occurs.

Explanation

The given statement implies that the clinic has a system in place where they can contact or call back patients in case of an emergency. This system is designed to ensure that urgent medical attention can be provided promptly when needed. Therefore, the statement is true.

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3. When an SCI patient comes to the clinic part of the assessment should include:  

Explanation

When an SCI patient comes to the clinic, it is important to assess their routine bowel and bladder care. This is because individuals with spinal cord injuries often experience difficulties with bowel and bladder function. Assessing their routine care in these areas helps to identify any issues or problems that may need to be addressed, such as bowel or bladder dysfunction, incontinence, or the need for catheterization. By assessing and addressing these issues, healthcare providers can help improve the patient's quality of life and overall well-being.

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4. Which of the following complaint/symptoms does not require the LPN to notify the RN? 

Explanation

Bruising is not a complaint/symptom that requires immediate notification of the registered nurse (RN) by the licensed practical nurse (LPN). While dysuria, blood sugar of 420, and hematuria can indicate underlying health issues that may require medical attention, bruising is a common occurrence and does not typically require immediate intervention.

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5. At the CBOC or primary clinic, once it has been determined that the patient will be committed for psychiatric treatment, he/she will have ________________ to prevent harm to safe and others.   

Explanation

Once it has been determined that the patient will be committed for psychiatric treatment, they will have 1:1 observation to prevent harm to themselves and others. This means that a staff member will be assigned to closely monitor the patient at all times, ensuring their safety and the safety of those around them. This level of observation is necessary in cases where there is a high risk of harm or self-harm, and it allows for immediate intervention if any concerning behavior or situation arises.

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6. Which one of the following statements are not true in regards to safe patient handling and movement policy.

Explanation

The statement "Safety Huddle/After Action Review Process are not required for near-miss fall incident" is not true. Safety huddles and after-action reviews are important components of safe patient handling and movement policies, and they should be conducted even for near-miss fall incidents. These processes help identify areas for improvement, analyze the causes of the near-miss incident, and implement measures to prevent future incidents.

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7. Which of the following orders can only be initiated by the RN after consult with the provider (select all that apply) :  

Explanation

Abdominal x-ray is the correct answer because it is a diagnostic test that requires a healthcare provider's order. The RN cannot initiate this order without consulting with the provider first. C&S (culture and sensitivity), BMP (basic metabolic panel), and A1C are laboratory tests that can be ordered by the RN without consulting the provider.

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8. Nurses who have had documented competency training may initiate laboratory, radiological, and consultation requests based on patient presenting history and /or symptoms.

Explanation

The statement is true because nurses who have undergone competency training are qualified to initiate laboratory, radiological, and consultation requests. This means that they have the necessary knowledge and skills to assess a patient's presenting history and symptoms and determine the appropriate diagnostic tests or consultations needed. This allows for timely and efficient patient care, as nurses can take immediate action based on their assessment.

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9. What is the correct procedure to verify a patient's identification?

Explanation

The correct procedure to verify a patient's identification is to ask the patient to state his/her full name and full social security number. This ensures that the patient provides their complete name and social security number, which are essential for accurate identification and record-keeping purposes. Asking for only the last name or last four digits of the social security number may not provide enough information to accurately identify the patient.

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10. If a patient present to the clinic with complaints of frequent nosebleeds and is on Coumadin what test would you expect be able to initiate according to the PACT protocol?  

Explanation

According to the PACT protocol, if a patient on Coumadin presents with frequent nosebleeds, the appropriate test to initiate would be PT, INR, PTT, and CBC. These tests are necessary to assess the patient's clotting ability, as Coumadin is a medication that affects blood clotting. PT (prothrombin time) and INR (international normalized ratio) measure the extrinsic pathway of clotting, while PTT (partial thromboplastin time) measures the intrinsic pathway. CBC (complete blood count) is done to check for any underlying conditions that may contribute to the nosebleeds.

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11. Every attempt should be made to  have a family member, friend, or acquaintance to act as "applicant for commitment" if possible.

Explanation

Having a family member, friend, or acquaintance act as an "applicant for commitment" is recommended because they can provide valuable insight into the individual's behavior and mental state. They may have observed signs of distress or concerning behavior that can help inform the decision to commit the individual. Additionally, having someone close to the individual involved in the process can provide emotional support and help facilitate communication between the individual and the healthcare professionals involved.

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12. What assessment tool does one use to document skin breakdown risks?

Explanation

The Braden Scale is the assessment tool used to document skin breakdown risks. This scale is widely used in healthcare settings to assess the risk of pressure ulcers in patients. It evaluates six different factors including sensory perception, moisture, activity, mobility, nutrition, and friction/shear. By using the Braden Scale, healthcare professionals can identify patients who are at a higher risk of developing pressure ulcers and implement appropriate preventive measures to mitigate the risk.

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13. What would you do if your SCI patient was experiencing signs and symptoms of autonomic dysreflexia?

Explanation

If a SCI patient is experiencing signs and symptoms of autonomic dysreflexia, it is important to take immediate action. Sitting the patient upright helps to alleviate the symptoms by reducing blood pressure. Taking the patient's blood pressure is necessary to monitor their condition and assess the severity of the dysreflexia. Seeking to eliminate the cause is crucial in preventing further complications and resolving the dysreflexia. Therefore, all of the above options (A, B, and C) should be done in order to effectively manage autonomic dysreflexia in a SCI patient.

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14. As a supplement to the hospital's Emergency Operations Plan, Primary Care staff are designated as "essential" personnel.  

Explanation

Primary care staff being designated as "essential" personnel means that they are considered crucial to the hospital's Emergency Operations Plan. This suggests that their presence and services are necessary during emergency situations in order to provide necessary care and support to patients.

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15. RN and LPNs can order consultations and preventative health screening.

Explanation

RN and LPNs can order consultations and preventative health screening. This statement is true. Registered Nurses (RNs) and Licensed Practical Nurses (LPNs) have the authority to order consultations and preventative health screening for patients. This allows them to assess the patient's condition and recommend appropriate measures for their healthcare. It is within their scope of practice and helps in providing comprehensive care to patients.

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16. What are the steps that should be followed if a patient is missing from your clinic?

Explanation

The correct answer is "Preliminary search, notify VA police, Goose Creek (Naval Weapons Station), or Beaufort (Quaterdeck), document in CPRS." This is the correct sequence of steps to be followed if a patient is missing from the clinic. The initial step is to conduct a preliminary search within the clinic premises. Following that, the VA police, Goose Creek (Naval Weapons Station), or Beaufort (Quaterdeck) should be notified about the missing patient. Finally, the incident should be documented in the CPRS (Computerized Patient Record System) for record-keeping purposes.

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17. Patients requiring home supplies such as diabetic supplies or dressing supplies (abdominal pads, kling, etc.) can only be ordered by the RN.

Explanation

Patients requiring home supplies such as diabetic supplies or dressing supplies can be ordered by healthcare professionals other than just the RN.

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18. If  you answer a call and the caller tells you there is a bomb in the  building, after the call is terminated, who should you notify first?

Explanation

After receiving a call where the caller claims there is a bomb in the building, it is important to notify the supervisor first. The supervisor is responsible for the overall management and coordination of the staff, and they have the authority to take immediate action and implement emergency protocols. They can then inform the appropriate authorities such as the police, director, and any other necessary personnel to ensure the safety of everyone in the building.

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19. The purpose of the PACT protocols is so that the RN only can initiate electronic orders based on patient presenting history and/or symptoms. 

Explanation

The statement is false because the purpose of the PACT protocols is not limited to allowing only the RN to initiate electronic orders based on patient presenting history and/or symptoms. The PACT protocols are designed to facilitate communication and collaboration among healthcare professionals, including nurses, physicians, and other members of the healthcare team. These protocols aim to improve patient care by ensuring accurate and timely exchange of information and efficient decision-making.

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20. Breathalyzer test may be performed by clinical staff to aid in makaing a determination of intoxication, no consent is required.  

Explanation

The statement suggests that a breathalyzer test can be performed by clinical staff without requiring consent. However, this is not true. In most cases, consent is required before conducting a breathalyzer test, as it involves collecting a person's breath sample, which is considered a form of personal information. Consent is necessary to ensure that the individual's privacy rights are respected and that the test is conducted in a legal and ethical manner. Therefore, the correct answer is False.

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21. In the clinic if it is noted that a Veteran has disappeared (wandered) and hif/her  absence is unexplained, staff will notify __________whho wil coordinate the search.

Explanation

The nurse manager is responsible for coordinating the search if a Veteran has disappeared in the clinic and their absence is unexplained. They will be notified by the staff and will take charge of organizing and directing the search efforts. The nurse manager is in a position of authority and has the necessary knowledge and resources to handle such situations effectively.

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22. A SCI patient is at risk for autonomic Dysreflexia if he/she has an injury at level __________or higher? 

Explanation

Autonomic Dysreflexia is a potentially life-threatening condition that can occur in patients with spinal cord injuries. It is characterized by a sudden and dangerous increase in blood pressure. The condition is more likely to occur in patients with injuries at or above the level of T6. Therefore, a SCI patient is at risk for Autonomic Dysreflexia if he/she has an injury at the T6 level or higher.

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23. When deaccessing an implantable venous access device (porta cath), you should use _________ to flush. 

Explanation

When deaccessing an implantable venous access device (porta cath), it is important to flush the device to ensure proper functioning and prevent clot formation. Normal saline is used initially to flush out any blood or medication residue from the device. However, normal saline alone does not prevent clotting. Therefore, it is followed by heparin, which is an anticoagulant, to maintain the patency of the device and prevent clot formation.

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24. A patient with a PICC line has come to the clinic for compliants of pain in the near the area her PICC line, you should check the patient for signs and sypmtoms of (select all that apply):  

Explanation

If a patient with a PICC line complains of pain near the area, it is important to check for signs and symptoms of complications. Leaking may indicate a problem with the PICC line, such as a loose or disconnected connection. Edema of the arms may suggest a blockage or clot in the PICC line causing poor blood flow. Erythema and redness may be signs of infection at the site of the PICC line insertion. These symptoms should be evaluated and addressed promptly to prevent further complications.

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25. After notifying the police of a bomb threat, who will ensure that your area (building) is vacant.  

Explanation

The nurse manager is responsible for overseeing the nursing staff and ensuring the safety and well-being of patients. In the event of a bomb threat, it is their duty to coordinate the evacuation of the area and ensure that the building is vacant. The nurse manager has the authority and knowledge to effectively manage the situation and ensure the safety of everyone involved.

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26. For patients that need to be commited to the psychiatric unit, a psychiatrist is the only person that can serve as the certifier and examing physician.   

Explanation

The statement is false because while a psychiatrist can serve as the certifier and examining physician for patients who need to be committed to the psychiatric unit, they are not the only person who can fulfill this role. Other mental health professionals, such as psychologists or psychiatric nurse practitioners, may also be qualified to serve as certifiers and examining physicians in certain situations.

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27. The CBOCs preliminary search sheet can be used for all CBOCs and clinics.

Explanation

The statement suggests that the CBOCs preliminary search sheet is applicable to all CBOCs and clinics. This means that the search sheet can be used universally across different facilities, indicating its versatility and usefulness.

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28. Which of the following orders can the LPN initiate (select all that apply):

Explanation

The LPN can initiate the orders for CBC, Renal Panel, and UA. These tests are within the scope of practice for an LPN and do not require a physician's order. A CBC (Complete Blood Count) is a common test that measures different components of blood, such as red and white blood cells. A Renal Panel is a group of tests that assess kidney function. UA (Urinalysis) is a test that examines urine for various markers of health and disease. A Chest x-ray, on the other hand, would typically require a physician's order and would be performed by a radiology technician.

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29. Upon learning of the probability of severe weather in the vicinity of the clinic, the _____________ shall direct all clinics staff members to review and follow the Emergency Operations Plan.  

Explanation

The lead physician is the most appropriate person to direct all clinic staff members to review and follow the Emergency Operations Plan in the event of severe weather. As the head of the medical team, the lead physician has the authority and responsibility to ensure the safety and well-being of both the staff and patients. They have the knowledge and experience to make informed decisions during emergencies and can effectively communicate and coordinate with the rest of the staff.

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30. If a patient at the clinic waiting for transfer to an inpatient mental health facility becomes violent or threatening, you should call the lead physician to check the patient. 

Explanation

You should call 911.

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31. The LPN should notify the RN or provider of the following complaints/symptoms of their patient (select all that apply).

Explanation

The LPN should notify the RN or provider of the patient's complaints/symptoms of SBP > 180 and shortness of breath with fever > 101.5 because these indicate potentially serious conditions that require immediate attention. Muscle joint discomfort and nausea and vomiting may also be important to report, but they are not as urgent as the first two symptoms.

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32. Who at the clinic will be responsible for taking the lead role in coordinating the observation of a patient that has been determined to be committed for psychiatric treatment?  

Explanation

The nurse manager will be responsible for taking the lead role in coordinating the observation of a patient committed for psychiatric treatment. As the manager, they oversee the nursing staff and ensure that all patients receive appropriate care. Coordinating the observation of a committed patient requires a high level of organization and communication skills, which are typically responsibilities of the nurse manager. The charge nurse may assist in the coordination, but the ultimate responsibility lies with the nurse manager. The lead physician may be involved in the patient's treatment plan, but they are not typically responsible for coordinating observation.

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33. What is the proper way to clean using CAVIWIPES?

Explanation

The proper way to clean using CAVIWIPES is to apply gloves, wipe the surface, and let it dry for 1 minute.

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34. A preliminary search for at risk missing patients should be initiated immediately and completed with in _________minutes.  

Explanation

A preliminary search for at-risk missing patients should be initiated immediately and completed within 30 minutes. This time frame allows for a prompt response to locate and ensure the safety of the missing patients. Waiting longer than 30 minutes could potentially increase the risk and harm to the patients. Therefore, it is crucial to act swiftly and efficiently to minimize any potential dangers.

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35. Upon termination of the call from a bomb threat, while the building (clinic) is being evacuated, who will call 911 and inform the police of the receipt of a bomb threat.  

Explanation

The correct answer is the Leam Team Physician. In the event of a bomb threat, it is important to inform the police as soon as possible. The Leam Team Physician would be responsible for making this call since they are a part of the medical team and would have the necessary information about the threat and the building evacuation. The Charge Nurse, Nurse Manager, and LPN may be involved in the evacuation process but would not have the specific information needed to inform the police.

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36. All CBOCs and clinics are laxtex free.

Explanation

The statement "All CBOCs and clinics are latex free" is false. This means that not all CBOCs and clinics are latex free.

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37. All suspected suicides will be reported to the following except:

Explanation

The correct answer is VA Police staff because they are not directly involved in mental health services or quality management. The other options, Quality Management, Director's Office, and Mental Health Service Line, are all departments or offices that would be involved in reporting and addressing suspected suicides. VA Police staff may be involved in responding to incidents or providing security, but they would not typically be responsible for reporting or addressing suspected suicides.

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38. A minimum of three employees will assit with all lifts/transfers of patients with limited mobility.

Explanation

The statement is false because it states that a minimum of three employees will assist with all lifts/transfers of patients with limited mobility. However, it does not specify any requirement for the number of employees needed. Therefore, it cannot be assumed that a minimum of three employees will always be required for these lifts/transfers.

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39. Ear irrigations are contraindicated in the following (select all that apply):

Explanation

Ear irrigations are contraindicated in cases of tympanic membrane perforation, middle ear disease, foreign body in the canal, and narrow ear canals. This means that if any of these conditions are present, ear irrigations should not be performed as they could potentially cause further damage or complications.

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40. If a patient presents to the clinic with complaints of having black tarry stools for the past two days, according to the PACT protocol, which orders can be initiated by the RN (select all that apply):  

Explanation

The PACT protocol is a set of guidelines followed by healthcare professionals to assess and manage patients. In this case, the patient's complaint of black tarry stools suggests gastrointestinal bleeding, which can be a serious condition. The CBC (complete blood count) can help determine if the patient is experiencing anemia due to blood loss. The PT/INR/PTT tests can assess the patient's blood clotting ability, which may be affected by the bleeding. The renal panel can provide information about kidney function, which may be affected by the bleeding. Amylase and Lipase tests are not directly related to the patient's complaint and would not be necessary in this situation.

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The Breathalyzer device's mouthpiece is a one time use and must be...
The clinic has a fan-out/call back system if an emergency occurs.
When an SCI patient comes to the clinic part of the assessment should...
Which of the following complaint/symptoms does not require the LPN to...
At the CBOC or primary clinic, once it...
Which one of the following statements are not true in regards to safe...
Which of the following orders can only be initiated by the RN after...
Nurses who have had documented competency training may initiate...
What is the correct procedure to verify a patient's...
If a patient present to the clinic with complaints of frequent...
Every attempt should be made to  have a family member, friend, or...
What assessment tool does one use to document skin breakdown risks?
What would you do if your SCI patient was experiencing signs and...
As a supplement to the hospital's Emergency Operations Plan,...
RN and LPNs can order consultations and preventative health screening.
What are the steps that should be followed if a patient is missing...
Patients requiring home supplies such as diabetic supplies or dressing...
If  you answer a call and the caller tells you there is a bomb in...
The purpose of the PACT protocols is so that the RN only can initiate...
Breathalyzer test may be performed by clinical staff to aid in...
In the clinic if it is noted that a Veteran has disappeared (wandered)...
A SCI patient is at risk for autonomic Dysreflexia if he/she has...
When deaccessing an implantable venous access device (porta cath), you...
A patient with a PICC line has come to the clinic for compliants of...
After notifying the police of a bomb threat, who will ensure...
For patients that need to be commited to the psychiatric unit, a...
The CBOCs preliminary search sheet can be used for all CBOCs and...
Which of the following orders can the LPN initiate (select all that...
Upon learning of the probability of severe weather in the vicinity of...
If a patient at the clinic waiting for transfer to...
The LPN should notify the RN or provider of the...
Who at the clinic will be responsible for taking the lead role in...
What is the proper way to clean using CAVIWIPES?
A preliminary search for at risk missing patients should be initiated...
Upon termination of the call from a bomb threat, while the building...
All CBOCs and clinics are laxtex free.
All suspected suicides will be reported to the following except:
A minimum of three employees will assit with all lifts/transfers of...
Ear irrigations are contraindicated in the following (select all...
If a patient presents to the clinic with complaints of having black...
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